Re: 1st. visit to a Neurosurgeon

March 2, 2000

<< The only testing I have had done is the brain MRI. What should I expect

the Neurosurgeon to do as part of a complete workup for Chiari? >>

Hi chris ...welcome to the suport group .....hmmm very good question , that

is not discussed much on the list . Below is a partial list " my " chiari

neurosurgeon said it the starting place , before considering any surgical

intervention ......i'll add small explainations why next to the

recomendations .

1. full brain and spine mris .....this to access the impacts of possible csf

flow problems , as well as determine the degree of herniation ...look for any

syrinx that may be present , ...tumors or teathering of the spinal cord . it

should be " head to tail " . It should include measurements to evaluate spinal

stenosis as well , when the radiologist or doctor you see , evaluates these .

2. plain xrays of the full skull and spine ...to look for bony abnormality

that may include ocult or hidden spinal bifida , scoliosis , basilar

impresion , ....xrays show bone best ....mris show soft tissues best .

2 . cine mri of the area of the chiari may be useful to see the csf flow

movement ( this is also known by other names now , including quanatative csf

flow study, and or cardiac gated cine study ,....but you dont want the sort

used for heart /blood flow workup ) . it is not available at all mri centers

as it requires special software is needed ....and many centers that have the

software dont know how to do this study correctly ...even fewer radiologists

are trained to read these ....so youll need to take the study dirrectly to

your doctor for evaluation . He or she , may prefer this be done at a center

where they have trained the technicians themselves .

other tests may well be sugested including those to access nerve conduction

....blood tests to check for other impacts that can be involved ect ....so

this is not ment to be a full list ...only a minimum starting place .

you dont want to jump into surgery , untill things like the possbile presence

of a syrinx and or spinal bifida are determined first .

hope thats of a bit of help ......sarah in paradise .....chiari , spinal

bifida oculta stuff , and multiple sclerosis ....much improved since

decompresion , but still having some diffcilties as well ,...( could be

chiari or ms , no sorting this one out well given current science ) .

ps .....shoveling is a huge trigger for me now ....( one i discovered only

recently ) ..please do consider recruiting a strong gardening assistant for

this ....i now trade supervision of some boy activites for help in the garden

from 2 young men ....they are delighted to have an adult watch em at

activites their parents dont have time for ...and i do leave that shoveling

to them :-)

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